Herpes Simplex is caused by herpesvirus homonomous types 1 and 2. Infections due to the virus are worldwide, and they are considered to be one of the most common sexually-transmitted diseases. Herpes Simplex affects 92 million Americans. Type 2 appears to be more neurogenic and accounts for about 80% of the genital infections. There is about a 60-80% risk of sexual passage of the infection in those repeatedly exposed to an infected conjugal partner, indicating that circulating antiviral antibodies, which rise fourfold following an outbreak, do not prevent superinfection. Type 1 Herpes Simplex is generally associated with infection in and around the mouth, and with other Herpes Simplex infections above the waist. Typically, it is characterized by a cluster of small blisters or watery vesicles on the skin or on mucus membranes. The lesions are commonly called cold sores or fever blisters. They most frequently occur on the lips and face and occasionally on the trunk and hands. The Type 1 virus may also infect the eye, causing corneal ulcers and visual impairment.
The occurrence of a lesion is often signalled by tingling with burning in the skin area, which becomes red and covered with vesicles. These vesicles break and form a crust. The skin appears normal within six to ten days after the onset of the lesion, unless there has been secondary infection. Lesions may often reappear at the same site for many years, and may be precipitated by any one of a number of factors, such as sunburn, upper respiratory and gastrointestinal tract infections, fevers, emotional stress, or anxiety.
Herpes Simplex Virus Type 2 is associated with genital infections. Herpes genital infections are most often transmitted through sexual contact. Sexual practices involving oral/genital contact may be responsible for some crossover infections, while other infections occur through hand/genital/mouth contacts. The incubation period for Herpes genital infection is usually four to five days, but may be as short as 24 hours and as long as two weeks. The first symptoms may be pain or itching at the site of infection. This is followed within a day or two by the appearance of blister-like lesions that may occur singularly or in groups. In males, the common sites of infection include the foreskin, the glans and the shaft of the penis. In females, the blister may occur on the labia, the clitoris, the opening of the vagina, or, occasionally, on the cervix. Within a few days, the blisters rupture and merge to form large areas of denuded tissue surrounded by swollen, inflamed skin. At this stage, the lesions may become exquisitely painful with intense burning and irritation. In females especially, urination may cause great discomfort. Generalized symptoms such as fever and malaise may develop, and lymph glands in the groin may enlarge. Lesions may persist at this stage for a week or more and complete healing may take four to six weeks. Genital herpes infections generally are more severe in females and may become so uncomfortable and disabling as to require hospitalization. Reoccurrences of herpes genital infection are not uncommon, and may be associated with emotional stress, trauma, intercourse, and other infections or menstruation. Symptoms may not be as severe in the recurrent infections as in the initial ones.
A variety of treatments have been used for genital herpes, but none has been entirely satisfactory. Drying agents such as alcohol, spirits of camphor, and ether have been used. Other methods of treatment include the use of ointments and creams, topical anesthetics, and antiseptic solutions. As of today, no satisfactory vaccine has been found. In superficial infections, topical agents such as Idoxuridine (IDU), Triflurothymidine, or Acyclovir are sometimes effective. General cleansing with soap and water is recommended, but keeping lesions moist may aggravate the inflammation and delay healing.